| NPI | 1417939257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35050816)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35050816Z)  | 
| Enumeration Date | 2005-11-17 | 
| Last Update Date | 2015-06-30 |